Joshua Swift no doubt had better things to do than listen to two reporters ask the same questions he hears every day.

He is, after all, the director of the Forsyth County Department of Public Health, and we are mired in the midst of a coronavirus pandemic.

Yet there he sat Thursday afternoon, talking about wearing face coverings and the spread of coronavirus in the community. Word was — is — that Gov. Roy Cooper might soon order their use. “When you’re wearing a mask, you are protecting each other,” Swift said.

(If you’re still wondering and/or refusing, odds are that you’re just a jerk. Wearing a mask won’t hide that.)

Down toward the end of the day’s second Q&A, Swift pivoted to another underappreciated point: the importance of contact tracing.

Forsyth County, so far, has paid attention to tracing the virus. The state, according to a national team of epidemiologists, not so much.

Slowing the roll

North Carolina, Gov. Roy Cooper in particular, is staring down the barrel of yet another artificial deadline to reopen segments of society.

He’s expected to say today how far he’s willing to go in a Phase 2.5 reopening of some businesses before Friday’s planned Phase Three, during which private bars, clubs and gyms would remain shuttered and indoor use of fitness centers and health clubs would likewise stay closed.

Odd, but bar and gym owners (and patrons) seem to have formed a loose, unlikely alliance in pressing for mass reopening. Nothing like wiping out the gains of a hard workout by knocking back a few beers.

The biggest hurdle, of course, remains the spiking number of coronavirus cases being reported.

As of Monday afternoon, that would be 53,605 positive cases in the state and 2,575 in Forsyth County. The number of dead statewide is 1,223; 28 of those are in Forsyth County.

Of equal concern is the number of coronavirus patients who require hospitalizations, number of available beds, ICU beds and ventilators.

Some 870 people were hospitalized Monday with COVID-19. According to a group of epidemiologists and other experts called COVID ActNow, North Carolina has about 2,174 ICU beds and of that 56 percent are occupied by non-COVID patients — enough for now, but that could change fast.

The pressure is squarely on Cooper and Dr. Mandy Cohen, the director of the N.C. Department of Health and Human Services; expect, at minimum, more face masks and pumping the brakes on throwing open saloon doors.

Beyond that, though, what else needs doing?

A large piece of the puzzle, as Swift alluded to, may well lie with contact tracing — the practice of interviewing people with coronavirus to find out where they’ve been and with whom they have had close person-to-person contact.

“We have 100 people doing contract tracing for every single positive case,” Swift said. “We’re very effective at finding out who (patients) have been in close contact with … meaning within 6 feet for more than 15 minutes or more.”

More tracing needed ASAP

A small army of trained contact tracers is a huge asset for Forsyth County.

One-hundred tracers working back on the 2,575 positive cases — 51 on Monday alone — seems a reasonable number. At least it sounds adequate for the time being, barring continued rapid surging of caseloads.

“We’ve done it (contact tracing) for years with other communicable diseases,” Swift said. “As cases go up, we will need more. We feel so far that we’ve been able to handle the amount of cases.”

Fair point. But the problem, as always, will be in passing word about clusters and positive cases.

Privacy laws hamstrung early efforts to release even rudimentary breakdowns by zip codes and state officials were slow to release crucial information about outbreaks in nursing homes.

“In terms of the (reporting) requirements there are state laws,” Cohen. “Those are confined to our congregate living settings (nursing homes), schools and child care,” she said. “Restaurants, churches, construction sites do not fall into that bucket. But we know that’s where the virus is being transmitted.”

Still, contact tracing is — has been — an important tool. “Contact tracers are trying to be thoughtful about understanding close contact and being targeted in their efforts,” Cohen said.

The state, though, may not be as well positioned as Forsyth County. COVID ActNow estimates that the state has 1,500 contact tracers.

“With an average of 1,245 new daily cases, we estimate North Carolina needs 6,225 contact tracing staff to trace all new cases in 48 hours, before too many other people are infected,” COVID ActNow reported in an update Sunday. “This means that North Carolina is likely able to trace 24 percent of new COVID infections in 48 hours.”

In other, plainer words: not enough. It “is unlikely that North Carolina will be able to successfully identify and isolate sources of disease spread fast enough to prevent new outbreaks.

The clock is ticking, and the meter is running. Get on with it.



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